39970 A4 "
41SAN JOSVle r BUILDING DEPARTMENT
1
APPLICATION FOR BUILDING PERMIT
Tract No. .-2562.... . Lot No. ___69 --- Plan No. C-3
Date........qq t.o-be-_r...I.... .................... 19._62. Permit No.S-91970-,....------
Application is hereby made for a permit to b_uild........................................I------------
a....Pne....story, Type------5---Re 5 id-e-n.c.e.With..attached. ga-r age................... Building
at --- Use Zone .�_?------- ---
Occupancy ...-I---------------
to a ccupied only as ----Z,falmik_resi.d. en ldokNg Space -----2-
cc
cc P11 f- n here
Ca ,,r,d ie� Not
Estimated Valu+f Improvements,
If is hereby agreed that the requirements of the Son Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will be
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so as to violate the workmen's compensation'laws of California.
Owner Oakley Organization , 6403 Bollinger'\Rd. , San Jose
wner ., ..... ................-=-....Address - _.......................................................
69WORF"dr ..Address ------------
ByAgent -
Form 280-1
RECORD OF INSPECTION'
Foundatio . ... ............. 2-6
.. ... ......;-2. Frame ----
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Stucco ---------------------------------- ----------------------- Finish --- -----------------
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PC.,-le C-V '-few, &,Wo D
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